Idiopathic VF Controlled Successfully With Phenytoin
Idiopathic VF Controlled Successfully With Phenytoin
We describe a case of an individual with idiopathic ventricular fibrillation whose arrhythmias were successfully controlled with phenytoin therapy.
Ventricular fibrillation (VF) is defined as "turbulent, disorganized electrical activity of the heart in such a way that the recorded electrocardiographic deflections continuously change in shape, magnitude, and direction." VF is categorized as idiopathic when structural and underlying electrical abnormalities are excluded. Accounting for 6–12% of all cases of VF, idiopathic ventricular fibrillation (IVF) has a male predominance of 2.5: 1 and accounts for an estimated 5% of all sudden cardiac death cases. It is estimated that VF accounts for approximate 300,000 deaths in the Western world on an annual basis.
There are 3 main streams for treatment of IVF including drug therapy, implantable cardiac defibrillator (ICD), and radiofrequency (RF) ablation therapy. According to the American College of Cardiology/American Heart Association guidelines, all survivors of IVF should receive an ICD. Antiarrhythmic drugs are used to decrease the number of shocks administered by ICD devices and also as a bridge therapy prior to implantation of ICD devices. Finally, a select group of patients will receive RF catheter ablation therapy as a mean for definitive management of the triggering sources. The following is the first reported case of IVF successfully treated with phenytoin therapy.
Abstract and Introduction
Abstract
We describe a case of an individual with idiopathic ventricular fibrillation whose arrhythmias were successfully controlled with phenytoin therapy.
Introduction
Ventricular fibrillation (VF) is defined as "turbulent, disorganized electrical activity of the heart in such a way that the recorded electrocardiographic deflections continuously change in shape, magnitude, and direction." VF is categorized as idiopathic when structural and underlying electrical abnormalities are excluded. Accounting for 6–12% of all cases of VF, idiopathic ventricular fibrillation (IVF) has a male predominance of 2.5: 1 and accounts for an estimated 5% of all sudden cardiac death cases. It is estimated that VF accounts for approximate 300,000 deaths in the Western world on an annual basis.
There are 3 main streams for treatment of IVF including drug therapy, implantable cardiac defibrillator (ICD), and radiofrequency (RF) ablation therapy. According to the American College of Cardiology/American Heart Association guidelines, all survivors of IVF should receive an ICD. Antiarrhythmic drugs are used to decrease the number of shocks administered by ICD devices and also as a bridge therapy prior to implantation of ICD devices. Finally, a select group of patients will receive RF catheter ablation therapy as a mean for definitive management of the triggering sources. The following is the first reported case of IVF successfully treated with phenytoin therapy.